Provider Demographics
NPI:1790030757
Name:HINES, ASHLEY CRISTEN (LMT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CRISTEN
Last Name:HINES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4137 NW 18TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-1976
Mailing Address - Country:US
Mailing Address - Phone:352-410-3470
Mailing Address - Fax:
Practice Address - Street 1:4137 NW 18TH DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-1976
Practice Address - Country:US
Practice Address - Phone:352-410-3470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 68067225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist